Eldercare Service Redesign in Finland: Deinstitutionalization of Long-Term Care

ABSTRACT

Deinstitutionalization is an important trend in the redesign of long-term eldercare in Finland. It refers to a process where traditional institutional care is partly replaced by home care services and the creation of homelike housing units. The first part of this article provides an overview of eldercare service redesign by using national statistics. The second part consists of qualitative analysis of the deinstitutionalization of eldercare. The data consist of 27 interviews conducted among municipal care administrators and is analyzed using thematic and discourse analysis. Main findings show a deep policy change taking place in eldercare deinstitutionalization discourse lying at its center. A distinction between explicit and implicit deinstitutionalization discourse is made. The former clearly states that institutional care needs to be cut back making it possible for all older people to live at home or in homelike housing facilities. Implicit deinstitutionalization discourse is underpinned by comments of a different type, more critical and problem-centered. Within intensive service housing, for instance, fee policy is reformed. The main results include the observation that explicit deinstitutionalization discourse is in line with the national policy aims of putting home first, while implicit discourse deals with hidden or unexpected consequences. The article discusses future research in the conclusion.